Prenatal Opioid Exposure and Maternal-Infant Coregulation as Indicators of Early Infant Neurodevelopment

Background: Little is known about the short- and long-term effects of prenatal opioid exposure on infant neurodevelopment. Infants with neonatal opioid withdrawal syndrome (NOWS) are often admitted to neonatal intensive care units (NICU) where the development of coregulation between mothers and infants is easily disrupted. Understanding early mother-infant coregulation is needed to guide intervention strategies for these high-risk mother-infant dyads. Purpose: Explore the impact of prenatal opioid exposure on mother-infant coregulation, as an indicator of early infant neurodevelopment, in response to a standardized stress experiment, the Still Face Paradigm (SFP). Methods: A prospective cohort design was used to enroll opioid-exposed (N = 11) and non-exposed (N = 13) mother-infant dyads, when infants discharged from the NICU were 6 to 9 months. Dyadic heart rate variability (HRV) data were used as a measure of coregulation and were recorded using heart rate monitors during the 3 phases of the SFP: (a) baseline, (b) still-face, or flat affect, and (c) reunion. We conducted analyses to determine differences within the HRV dyad profiles. Results: HRV profiles differed between the 2 study groups. In the opioid-exposed group: (a) infants exhibited more irregular autonomic processes, (b) mothers had higher HRV baselines, and (c) there was an overall dysregulation between mothers and infants compared to the non-opioid exposed group. Implications for Practice and Research: These differences may suggest that prenatal opioid exposure contributes to difficulty with dyadic co-regulation which may negatively impact early infant neurodevelopment. Additional research is needed to better understand the role of prenatal opioid exposure in infant neurodevelopment.